Jean-Pierre ELKABBACH: A noteworthy psychoanalyst, Jacques Alain Miller, good morning

Jacques Alain MILLER: Good morning

Jean-Pierre ELKABBACH : A elected politician from the UMP, a physician, Bernard Accoyer, good morning.

Bernard ACCOYER : Good morning

Jean-Pierre ELKABBACH : The psy world is heated and it's you, Bernard Accoyer, who turned the heat on with your amendment, which carries your name and was unanimously voted by the Assemblee representatives a few days ago. You request that professions engaging in psychical treatments be ruled. Why are they in the viewfinder of the Asemblee?

Bernard ACCOYER : I did absolutely not intend to heat up anything, this is an old debate regarding the need to provide greater information and details to those feeling the need to receive aid or treatment with psychological purposes. It so happens that in France there is a legal vacuum whereby anyone may announce himself as a psychotherapist. Thus, whoever is psychologically suffering or needy will go though his door and meet a person holding no guarantee for his knowledge or his seriousness.  

Jean-Pierre ELKABBACH : It is true that psys can be found everywhere today: psy this, psy that, at businesses, at offices, at the press. I believe there are 36,000 psychologists, nearly 30,000 psychotherapists and nearly 13,000 psychiatrists.

Bernard ACCOYER : Under the term psychotherapist there is nothing defined. Therefore, this probably includes the best but probably also the worst. Therefore, without a concern for information, for sanitary security, for access guaranteed at a given level of competence and professional knowledge on the part of the State, which is essential in matters of public care and health, there is an old debate going on and a need to provide information. This is the content of this amendment, it is an old issue I have been working at for four years, which was almost finished at the time of Bernard Kouchner, which has been the subject of a colloquium with the leading figures.

Jean-Pierre ELKABBACH : So you launch it again. Bernard Accoyer, you propose very strict rulings which would become a law if the Senate agrees with you within a few weeks. Why? Is it also a market?

Bernard ACCOYER : Yes, of course it is a market, but the problem is not there. The problem is sanitary security. The rules are not so strict. They only require from women and men wishing to provide care (which is something we should congratulate ourselves about) to obtain a certain number of diplomas, of knowledge and evaluation of their practice.

Jean-Pierre ELKABBACH : Do you mean to say there should be less?

Bernard ACCOYER : The number is not important. What I wish is that those who believe they can and will benefit from treatment, that it be a treatment provided by professionals who know psychological ailments, psychological pathologies, and thus will engage in good treatments because we know that an ill-conducted psychotherapy may bring about dramatic consequences.

Jean-Pierre ELKABBACH : Bernard Accoyer, are you including France's 5,000 psychoanalysts in the same batch?

Bernard ACCOYER : But psychoanalysis is a separate psychotherapy on which it is necessary, as is actually happening today, to have exchange, discussions. This said, is psychoanalysis is a treatment, then it must by necessity, like all other treatments, be validated, in any case, the professionals practicing it should be controlled, evaluated at any given time and a priori at the beginning of their exercise.

Jean-Pierre ELKABBACH : All right, we shall ask for the opinion of one of the most known and recognized psychoanalysts, not only because he is Jacques Lacan's son-in-law, Jaques Alain Miller. How do you feel affected by what Bernard Accoyer has just said?

Jacques Alain MILLER : Listen, I greatly appreciated Mr Accoyer's tone, the one he has this morning, because we are all in a confidence crisis situation. I could fear the generation of a panic of the kind "All are quacks!" In social life you must trust. And when you cannot trust, when sudden breaches of confidence occur, then panic is aroused.

Jean-Pierre ELKABBACH : But you too said in Le Monde, Jacques Alain Miller, that there are sects, a "psy business" of people circulating folly.

Jacques Alain MILLER : Why are there so many psychotherapists? Why has this grown in such a way? Because there is nobody that can be trusted, particularly one person, whereas in present-day social life we are forced to trust extremely complex systems of which we have no mastery

Jean-Pierre ELKABBACH : There are those who have an education, who know medicine and science, and there are so many others!

Jacques Alain MILLER : Yes, certainly. And where there is a breach of confidence, politicians know that, because when there are breaches of confidence it is they who are held responsible. Well, Mr Accoyer's initiative has not been understood. It has the merit of having felt that the question of psychotherapies had already become a political issue. Therefore, it should be dealt with at the political level, yet it must be dealt with intelligently, understanding the cultural stakes it involves. The first service I can do to Mr Accoyer is to tell him that he has made a mistake, that it is not so bad if it is corrected right away. His first mistake, if I may say so, is not to have taken counsel with me.

Jean-Pierre ELKABBACH : You will take care of your ego elsewhere. 

Jacques Alain MILLER : Next, the risk should not be dealt with as a threat because this generates an atmosphere of panic which does not spare politicians.

Jean-Pierre ELKABBACH : What is it the, that you ask from Bernard Accoyer this morning, Jacques Alain Miller?

Jacques Alain MILLER : I ask him to withdraw this amendment and deal with the risk, because we are in a risk society, to deal with the risk in a rational manner, including the reasons for the present state of affairs. I believe he already understood something when he said this morning that things should not be taken dramatically. There is no need to offend therapists, to scare patients. Then many things will become possible, and they are necessary. And as they say, we asked about it long ago, and we came to realize that this question has become a political issue.

Jean-Pierre ELKABBACH : Is it possible? I look at a book you published at Seuil two years ago "Qui sont vos Psychanalystes?", this is quite a while ago, and you say "It is about time for analysts to be questioned, to be shaken, to be urged to explain themselves, to show themselves, to struggle for their bread." Therefore, Bernard Accoyer, is it possible to withdraw or correct your amendment?

Bernard ACCOYER : My amendment is relevant to those who treat, and those who treat should have, and that is a rule for all ailments, mental or bodily, should have a minimum of knowledge, control of knowledge, and control of their practice. It goes no further than that.

Jean-Pierre ELKABBACH : Do you agree? Do you agree with that, Jacques Alain Miller?

Jacques Alain MILLER : The issue is whether this problem should be dealt with by a law or not. Perhaps, but it is a issue for debate.

Jean-Pierre ELKABBACH : I go back to my question.

Bernard ACCOYER : Yes?

Jean-Pierre ELKABBACH : Is it possible to withdraw or correct the amendment?

Bernard ACCOYER : First of all it cannot be withdrawn because it was unanimously adopted at the Assemblee Nationale. Application decrees will ensue for the definition.

Jean-Pierre ELKABBACH : If the senators agree with you .

Bernard ACCOYER : Yes, if the senators agree with us, of course. There will be application decrees. In particular regarding the problem of psychoanalysis, there may be special clauses, yet these cannot circumvent, if psychoanalysis enrolls as a treatment of the psyche, which can enroll only in a frame of evaluation and control of knowledge and practices. It is a matter of sanitary security.

Jean-Pierre ELKABBACH : Still another word from Jacques Alain Miller, and I will thank you, Bernard Accoyer.

Jacques Alain MILLER : Security in matters of mental health requires first and foremost that the means of psychiatry be enlarged.

Bernard ACCOYER : That is absolutely true, and it is the first step in the direction of the great failure of our system of care in the field if psychological and psychiatric ailments if this is not the first step.

Jacques Alain MILLER : Psychiatry is presently caught inside a logic of accounting. From this it ensues that violence at schools, suicide in the young, deadly enactments by mentally diseased who are insufficiently followed up like we saw at the Nanterre slaughters, which truly threaten the population and its representatives, it is the accounting logic in which psychiatry is presently enrolled which is a powerful factor of public insecurity. 

Jean-Pierre ELKABBACH : Thank you Mr Accoyer.

Bernard ACCOYER : Thank you.

Jean-Pierre ELKABBACH : Beyond fashions, Jacques Alain Miller, the French are great consumers of psy. Why this need? Today you cannot turn on the TV or read a newspaper without coming across an account by someone depressed.

Jacques Alain MILLER : Present-day social life is wrapped up in such complex, abstract, impersonal networks, that there is an effect of withdrawal into oneself, into what Michel Foucault called the le souci de soi. Then they say: "It's individualism, It's narcissism," it is because the modern subject, the modern Frenchman finds within himself, seeks within himself an area of inner security. I mean to say that the trust you cannot find outside, you try to find it within yourself. And that is why the contemporary ailment par excellence, is depression. It is the loss of self-confidence.

Jean-Pierre ELKABBACH : In your books you say...

Jacques Alain MILLER : As a last refuge.

Jean-Pierre ELKABBACH : But in your books you often say that the French are historically nervous and today, enervated.

Jacques Alain MILLER : Yes, that's absolutely correct. Nowadays in France there is a feeling of insecurity. And it should be known that we are already living in a risk society with the French nervousness which brought about a number of revolutions during the 19th century, isn't that so?, it easily becomes a society of fear. And, it, French society, is threaded by panic waves. They leave us.

Jean-Pierre ELKABBACH : Mr psychoanalyst, what are the remedies?

Jacques Alain MILLER : Therefore it is easy to conclude: They leave us in the hands of quacks. There, then, excuse me! Listen to the resonance of the speech of what should be called a spiritual authority: Do not fear.

Jean-Pierre ELKABBACH : Don't you believe that those who take care should be told from those who destroy? Those who do good to the individual, to the Frenchman I am, and those who do evil?

Jacques Alain MILLER : Of course.

Jean-Pierre ELKABBACH : Because they are not competent, because they are not qualified, because they don't have the diplomas, because they don't have the experience.

Jacques Alain MILLER : Mr Elkabbach, don't try to create panic. The media has a heavy responsibility here. It is very difficult for you to find the just measure of how to warn the public against problems but most of all, most of all, not to create panic.

Jean-Pierre ELKABBACH : Jacques Alain Miller, which are the remedies? Should we all be treated as a block? Or one by one?

Jacques Alain MILLER : Analysts, psychoanalysts today, should be capable of conveying to the Nation, to its representatives like Mr Accoyer and others, a certain amount of knowledge they possess and that can indeed take care of these panic waves that burst out periodically, which send valuable men to court, including High Court, and that I wish that from now on, a certain kind of discourse should change. I found in the moderation of Mr Accoyer's remarks a first step in this direction. I wish he would take the second which is natural, not at all humiliating, and withdraw an amendment which was preceded by absolutely no public debate whatsoever.

Jean-Pierre ELKABBACH : In any case, the debate has begun. Bernard Accoyer, Jacques Alain Miller, thank you.

Translation by Liliana Singer.

UQBAR-Translation